Once a monochorionic placenta is determined,
with or without a diagnosis of TTTS, we strongly advocate
weekly ultrasounds from 16 weeks through delivery of the babies
and for you to give your patient a TTTS Foundation brochure.
We will then mail them more information. The majority of parents
want to become educated on the risk of TTTS even if they are
not yet diagnosed. If they are diagnosed, we will overnight
our TTTS book by Federal Express so they will receive it immediately.

Encourage the diagnosed family to contact the Foundation.
They may call toll-free at 800-815-9211. They may also reach
us online at tttsfoundation.org.

Go over the list of questions, that we have provided, with
the diagnosed family. Give them a copy of the questions
and tell them you will go over them at each visit. This will
give them the perspective they need to see where they are
in the diagnosis of the disease. The goal is to narrow the
huge amount of information on TTTS to only what is relevant
to 'their' babies and 'their' pregnancy. The measurements
will let them be able to focus on what they need to fight.
They will also help them understand 'why' things would be
improving or taking a turn for the worst. With this specific
information, they will gain a sense of control.

Let parents know that you will be helping them create a plan
of action, with backup plans, based on the answers
to the questions. Let them know you are not taking the wait
and see approach. You may give them a copy of the enclosed
plan of action or they will get it in the 'parent version'
of this book.

Start your patient on nutritional therapy
of 3 cans of Boost protein drinks a day along with immediate
bedrest. You may read more about this therapy in the Nutrition
and Bedrest section of this book. You may also contact Dr.
Julian De Lia at 414-447-3535. Dr. De Lia may be also reached
online at tttsmd.com.

Once your patient has been diagnosed with TTTS, please
begin to fill out the enclosed registry to help with our research.
Your help would be deeply appreciated.